January 19, 2009

BodyLogicMD Chief Medical Officer, Dr. Jennifer Landa Congratulates Oprah For "Starting The Positive Conversation" on Bioidentical Hormones "Oprah Presented An Open-Minded, Balanced, informative program."

BodyLogicMD's Chief Medical Officer stated she "was very pleased by the balanced show Oprah did on bioidentical hormone therapy." Oprah echoed many of our patient's sentiments of some of the symptoms of perimenopause and menopause as "having the life force sucked out of you" and feeling "flat." Much like we tell our patients, Oprah felt that it was important for women [and men] to take control of their health and "start a conversation about what their various options were." She feels that every woman should make the decision for herself but make sure she is armed with the knowledge that she has options and needs to do the research to find out what is right for her.

Robin McGraw, the author of "What's Age Got to Do with It," described her journey through menopause. She noted that her symptoms started almost 10 years before her menopause. One of the important things she realized during that time was that "it's not selfish to put yourself first." She spoke about the importance of finding the information that made the most sense to you and not letting anyone tell you

that you're "fine" if you're sure that you are not. Robin described a situation when she first had symptoms and was told she was in menopause and "life as she knew it was over." She was then given a number of prescriptions to take including an antidepressant (she never took them). Interestingly, Robin talks about her symptoms starting when she was having difficulty with her son leaving for college and talked about "the empty nest syndrome." Landa believes McGraw's initial symptoms may have been triggered by stress. BodyLogicMD affiliated physicians often see their patients? symptoms of perimenopause and menopause beginning with or being aggravated by stress. This often happens because progesterone is a hormone that is needed to balance estrogen - it stabilizes the uterine lining, breast tissue and creates a sense of calm. Progesterone is also the precursor hormone for cortisol, the stress hormone. Therefore, the more stress you have, the more progesterone you divert over to make the cortisol you need and the less progesterone you have available to balance your estrogen.

Robin discussed her symptoms as hot flushes and night sweats but also "feeling melancholy" and "losing excitement for everything I was doing in my life." She is a big proponent, as are we, that people do their research prior to making the decision to seek out bioidentical hormone replacement therapy. We tell our patients to ensure that they have found a highly trained, expert physician who is connected to a quality compounding pharmacy and who will use comprehensive test results to determine whether or not there is a need for BHRT. McGraw talked about finding Dr. Prudence Hall after her research and was pleased that she took the time to explain everything to her, and, more importantly, took the time to listen to her. All things that BodyLogicMD affiliated physicians pride themselves on - most of all providing excellent care to their patients and treating them like individuals. They worked together as a team and developed a plan for Robin that included bioidentical hormones as well as a diet, nutritional supplement and exercise plan. This combination has helped Robin to "feel better than I ever have in my life." She states that it is important to keep following the hormone levels and your symptoms and "tweak, tweak, tweak."

Dr Christian Northrup, author of "The Wisdom of Menopause", did an excellent job reviewing the history of hormone use in the United States from the 1960's until today. She reviewed the 2002 Women's Health Initiative and discussed the confusion regarding hormone replacement therapy which has escalated since that time. The hormones that BodyLogicMD supports are termed "bioidentical". That simply means that those hormones have the exact same chemical structure as the hormones we would normally make in our bodies. Because they have the exact same structure, they have the exact same shape and can fit in EVERY receptor in the body that they are supposed to fit into. They can also be metabolized the way the body would normally metabolize them. Non-bioidentical hormones (sometimes referred to as 'synthetic?) have some difference in the hormone structure from what is naturally produced in the body. This difference is normally introduced into the hormone to allow it to be patented (things that are identical to nature cannot be patented). Even if the structural difference is small, the non-bioidentical hormone will NOT be EXACTLY the same shape and size as the hormone the body would have normally made. Therefore it will not fit exactly on EVERY receptor for that hormone in the body. This is how you get some of the effects of the natural hormone but not others effects. There are also differences in the way these non-bioidentical hormones are metabolized. Some of the controversy with the Women's Health Initiative study is that the study used non bioidentical conjugated horse estrogens and non-bioidentical progestins which, together, have shown an increased risk of breast cancer. There are some people who say that all hormones would cause an increase in breast cancer and others who say that the non-bioidentical hormones increased the risk more than a balanced bioidentical hormone would have. Landa believes that " you can't compare the two different types of hormones directly." Dr Prudence Hall described a study of 28,000 Swedish women on bio-identical hormones who were evaluated for 12 different causes of death. The study states that women on bioidentical hormones had lower death rates for all 12 causes.

Dr Wulf Utian, the President of the North American Menopause Society, expressed concern over the use of bioidentical hormones. He stated that some sites claimed that bioidentical hormones were safer and that the recommended treatment for a woman with menopausal symptoms was the lowest dose of hormone possible for the shortest amount of time. Dr Christian Northrup agreed that you would want to use the lowest dose necessary. She also agreed that patients should not get their hormones from sites that supply them without requiring that the patient be seen by a physician. Dr Northrup discussed the partnership necessary between the patient and the physician.

During her show, Oprah introduced us to a couple of women who have been suffering from severe menopausal symptoms. They complained of significant difficulty sleeping, weight gain, fatigue, hot flushes and night sweats, mood swings and "not feeling like me". One of the frustrations that Robin, Oprah and some of the other women discussed was being told that "everything was fine" and "the tests were in the normal range" when they knew that there was something wrong with them. Doctors that practice functional and anti-aging medicine like Dr. Northrup, Dr. Hall and the doctors at BodyLogicMD often look at different types of labs including serum (blood), urine and saliva. They also study the numbers a different way and may be able to spot imbalances that other doctors don't readily see - this is where "the art of testing" comes in to play. Doctors that practice this way often train for many hours beyond their medical school and residency to gain the unique understanding of functional and anti-aging medicine. Landa reflects that she "finds it very interesting to be using much more of the basic science information that I learned in the first 2 years of medical school then forgot in the last 2 years of medical school and the years of residency. I had to relearn so much of my early medical school years, but it makes medicine so much more meaningful to me and my patients."

Dr Oz went with one of the women to see Dr. Prudence Hall who evaluated her and recommended bioidentical estradiol and progesterone. The patient visited the show today after 1 week on the therapy and stated that she felt much better already. Dr Oz is going to visit a compounding pharmacy in a few more weeks.

"I applaud Oprah on her willingness to initiate this conversation with America. There is so much more to discuss! She has presented an open-minded, balanced, informative program. I am very excited to see her upcoming shows on the compounding pharmacies and with Suzanne Somers!" says Landa.